Health Sector

Explore the challenges and strategies to deal with health sector corruption

Corruption in the health sector is especially critical in developing and transitional economies lacking in public resources. Corruption lowers the quality, equity, volume and effectiveness of health care. It increases the price of medical services, and discourages people to use and pay for them. This has a corrosive impact on a population's level of health.

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Select global initiatives in the area of good governance and medicines have been particularly useful in generating a political and policy dialogue around the issue of pharmaceutical system good governance. The initiatives examined in this paper have been taken by the World Bank, the WHO and the Global Fund, as well as the Medicines Transparency Alliance. The main findings include that these initiatives identify weaknesses in the pharmaceutical system and can provide important baseline data. Recommendations include the need for political analysis, monitoring and evaluation, and the streamlining and uniformity of assessment tools across institutions.

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GlaxoSmithKline executive confessed to paying bribes for doctors to prescribe their medicine and for hospitals to carry it. The bribes get absorbed into the cost of the companies and raises prices of the drugs. BBC interviewed five drug salesman who confirmed this practice. There is also corruption going on around the health sector, such as people selling appointments to see physicians. http://www.bbc.co.uk/news/world-asia-china-23677468

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This study was designed to explore perceptions of per diems among government and non-governmental organization (NGO) officials in Malawi and Uganda, including risks for abuse. The study found that although per diems provide benefits such as encouraging training, respondents voiced many discontents about per diems, stating that they create conflict, contribute to a negative organizational culture where people expect to be paid for all activities, and lead to negative changes in work time allocation. Work practices are also manipulated in order to maximize financial gain. To curb abuse of per diems, initiatives must reduce pressures and incentives to abuse, while controlling discretion and increasing transparency in policy implementation. Donors can play a role in reform by supporting development of policy analysis tools, design of control mechanisms and evaluation of reform strategies.

This study measured implementation progress for a financial reform to promote accountability, transparency and good governance in the hospital sector in Lesotho. The authors found that despite some efforts on the national level to promote and support reform implementation, staff at the hospital level had made almost no progress in transforming institutions and systems to fully realize reform goals. Problems were traced to a complex reform design, inadequate capacity, professional boundaries, and weak leadership. The Lesotho reform experience suggests that less complex designs for budget reform, better adapted to the context and realities of health sectors in developing countries, may be needed to improve governance.